Effectiveness of empirical <i>Helicobacter pylori</i> eradication therapy with furazolidone in Russia: results from the European Registry on <i>Helicobacter pylori</i> Management (Hp-EuReg)

Background. First-line therapy does not always provide a high level of Helicobacter pylori eradication due to the increase of H. pylori resistance to antibiotics; therefore, it remains necessary to identify the most effective rescue treatments. The purpose of this study was to evaluate the efficacy and safety of empirical H. pylori furazolidone-containing regimens. Materials and methods. Adult H. pylori infected patients empirically treated with furazolidone-containing eradication regimens were registered in an international, prospective, multicenter non-intervention European registry on H. pylori management (Hp-EuReg). Data were collected at AEG-REDCap e-CRF from 2013 to 2021 and the quality was reviewed. Modified intention-to-treat (mITT) effectiveness analyses were performed. Results. Overall 106 patients received empirical furazolidone-containing therapy in Russia. Furazolidone was prescribed in a sequential scheme along with amoxicillin, clarithromycin and a proton pump inhibitor in 68 (64%) cases, triple regimens were prescribed in 28 (26%) patients and quadruple regimens in 10 (9.4%). Treatment duration of 7 days was assigned to 2 (1.9%) patients, 10-day eradication therapy in case of 80 (75%) and 14 days in 24 (23%) patients. Furazolidone was mainly used in first- (79%) and second-line (21%) regimens. The methods used to diagnose H. pylori infection were: histology (81%), stool antigen test (64%), 13C-urea breath test (6.6%), and rapid urease test (1.9%). The mITT effectiveness of sequential therapy was 100%; 93% with the triple therapy and 75.5% with quadruple therapy. Compliance was reported in 98% of cases. Adverse events were revealed in 5.7% of patients, mostly nausea (3.8%). No serious adverse events were reported. Conclusion. Furazolidone containing eradication regimens appear to be an effective and safe empirical therapy in Russia

Phylogeographic structure of the Common hamster (Cricetus cricetus L.): Late Pleistocene connections between Caucasus and Western European populations.

The Common hamster (Cricetus cricetus) is one of the most endangered mammals in Western and Central Europe. Its genetic diversity in Russia and Kazakhstan was investigated for the first time. The analysis of sequences of an mtDNA control region and cytochrome b gene revealed at least three phylogenetic lineages. Most of the species range (approximately 3 million km2), including central Russia, Crimea, the Ural region, and northern Kazakhstan), is inhabited by a single, well-supported phylogroup, E0. Phylogroup E1, previously reported from southeastern Poland and western Ukraine, was first described from Russia (Bryansk Province). E0 and E1 are sister lineages but both are monophyletic and separated by considerable genetic distance. Hamsters inhabiting Ciscaucasia represent a separate, distant phylogenetic lineage, named "Caucasus". It is sister to the North phylogroup from Western Europe and the contemporary phylogeography for this species is discussed considering new data. These data enabled us to develop a new hypothesis to propose that in the Late Pleistocene, the continuous range of the Common hamster in the northern Mediterranean extended from the central and southern parts of modern France to the Caucasus; however, its distribution was subsequently interrupted, likely because of climate change

List of samples localities.

<p>Point numbers correspond to <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0187527#pone.0187527.g001" target="_blank">Fig 1</a>.</p

Divergence time (kya) between the Common hamsters phylogenetic lineages as evaluated based on suggested (1) <i>Tscherskia triton and (Cricetulus migratorius + Allocricetulus eversmanni + Cricetus cricetus)</i> clade and (2) Pannonia and North-type lineages separation time.

<p>Divergence time (kya) between the Common hamsters phylogenetic lineages as evaluated based on suggested (1) <i>Tscherskia triton and (Cricetulus migratorius + Allocricetulus eversmanni + Cricetus cricetus)</i> clade and (2) Pannonia and North-type lineages separation time.</p

The hypothetical ranges of the Common hamster hyplogroups: Vertical hatching–Late Pleistocene Northern Mediterranean; horizontal hatching–south-western LGM refugium; filled with colors–modern (mid-20th century).

<p>Note: Atlantic ocean, Mediterranean, Black and Azov sea max. regression, Caspian sea max. transgression coast line shown with the dashed line.</p

Sample distribution map.

<p>Bryansk Province in Western Russia is indicated by a square, localities from the Ciscaucasian area by triangles, and the others by circles. In the breakout: Nalchik City is shown by dark blue, the Nalchik surrounds (restricted by 25-km radius) by light blue, Kislovodsk by red, and other localities by yellow.</p

Cladogram resulting from Bayesian phylogenetic analysis of haplotypes of concatenated sequences of <i>cytb</i> gene and control region for hamsters within the investigated area.

<p>Support values are given if they exceeded 0.5 for nodes that included three or more haplotypes. For GenBank accession numbers see <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0187527#pone.0187527.t002" target="_blank">Table 2</a>.</p

Phylogram resulting from Bayesian phylogenetic analysis of 904 bp cyt<i>b</i> gene fragment haplotypes.

<p>Support values are given if they exceeded 0.5 for nodes that included three or more haplotypes.</p

Role of proton pump inhibitors dosage and duration in Helicobacter pylori eradication treatment: Results from the European Registry on H. pylori management

Background: Management of Helicobacter pylori (H. pylori) infection requires co-treatment with proton pump inhibitors (PPIs) and the use of antibiotics to achieve successful eradication.Aim: To evaluate the role of dosage of PPIs and the duration of therapy in the effectiveness of H. pylori eradication treatments based on the 'European Registry on Helicobacter pylori management' (Hp-EuReg).Methods: Hp-EuReg is a multicentre, prospective, non-interventionist, international registry on the routine clinical practice of H. pylori management by European gastroenterologists. All infected adult patients were systematically registered from 2013 to 2022.Results: Overall, 36,579 patients from five countries with more than 1000 patients were analysed. Optimal (&gt;= 90%) first-line-modified intention-to-treat effectiveness was achieved with the following treatments: (1) 14-day therapies with clarithromycin-amoxicillin-bismuth and metronidazole-tetracycline-bismuth, both independently of the PPI dose prescribed; (2) All 10-day (except 10-day standard triple therapy) and 14-day therapies with high-dose PPIs; and (3) 10-day quadruple therapies with clarithromycin-amoxicillin-bismuth, metronidazole-tetracycline-bismuth, and clarithromycin-amoxicillin-metronidazole (sequential), all with standard-dose PPIs. In first-line treatment, optimal effectiveness was obtained with high-dose PPIs in all 14-day treatments, in 10- and 14-day bismuth quadruple therapies and in 10-day sequential with standard-dose PPIs. Optimal second-line effectiveness was achieved with (1) metronidazole-tetracycline-bismuth quadruple therapy for 14- and 10 days with standard and high-dose PPIs, respectively; and (2) levofloxacin-amoxicillin triple therapy for 14 days with high-dose PPIs. None of the 7-day therapies in both treatment lines achieved optimal effectiveness.Conclusions: We recommend, in first-line treatment, the use of high-dose PPIs in 14-day triple therapy and in 10-or 14-day quadruple concomitant therapy in first-line treatment, while standard-dose PPIs would be sufficient in 10-day bismuth quadruple therapies. On the other hand, in second-line treatment, high-dose PPIs would be more beneficial in 14-day triple therapy with levofloxacin and amoxicillin or in 10-day bismuth quadruple therapy either as a three-in-one single capsule or in the traditional scheme